MedTrainer

APRIL 18, 2024

Ambulatory surgery centers (ASCs) credential providers in much the same way as other healthcare organizations with some unique differences. The Accreditation Association for Ambulatory Healthcare (AAAHC) and The Joint Commission have extensive credentialing and privileging requirements for ASCs.

Licensing 52

Licensing Malpractice Compliance 52

Healthcare IT Today

OCTOBER 20, 2023

Netsmart today announced the acquisition of Netalytics , a South Carolina-based addiction treatment software and practice management company, dedicated to developing technology for substance use disorder (SUD) providers focused on opioid addiction treatment.

Regulatory Compliance 102

Regulatory Compliance Nursing Homes Nurses Compliance 102

MedTrainer

OCTOBER 13, 2023

What Is the Biggest Challenge in Healthcare Credentialing? Most payers created their own portal, most state and federal government agencies brought documents and databases online, and tech companies did their best to streamline processes. It’s clunky to move between them and downright irritating every time you have to login.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

APRIL 18, 2024

Behavioral health credentialing exploded in 2023 and 2024 as providers could enroll in Medicare for the first time. With a whole new group of provider enrollments starting from scratch, credentialers will likely be juggling towers of documents and data for the foreseeable future.

Medicare 52

Medicare Medicare Licensing Compliance 52

MedTrainer

APRIL 17, 2024

Federally qualified health centers ( FQHCs ) are mandated to provide comprehensive healthcare services to medically underserved areas and populations, including those with limited access to healthcare due to factors such as income, location, or insurance status. Many payers require providers to maintain a CAQH ProView profile.

Licensing 52

Licensing Compliance 52

Healthcare Law Blog

DECEMBER 15, 2022

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

MedTrainer

APRIL 17, 2024

Telehealth offers patients greater access to healthcare services and providers get more flexibility in their schedules. However, telehealth credentialing can be a challenge since many providers now cross state lines with different requirements and accept more types of insurance.

Licensing 52

Licensing Compliance Fraud Nurses 52

Provider Trust

JULY 26, 2023

Provider data is a fundamental driving force in the healthcare industry. When patients need care, they search through a provider directory to find someone in their healthcare network or plan that can provide them with the medical services they need. Correcting inaccuracies in provider directories is crucial.

Medicaid 52

Medicaid Medicaid Compliance Medicare 52

MedTrainer

NOVEMBER 17, 2023

With so many layers, requirements, and evolving regulations, it’s no wonder thousands of healthcare organizations feel lost in the sauce. While delegated credentialing adds another layer, it might help your healthcare organization get providers credentialed and enrolled more quickly.

Patient Satisfaction 52

Patient Satisfaction Hospitals 52

Health Populi

SEPTEMBER 27, 2023

“Report” is one word for this nearly 150-page compendium of health care data that is a treasure trove for health service researchers, marketers, strategists, journalists, and those keen to explore questions about the current state of health care in America. The Report synthesizes a database covering |300M American lives and 2.7M

COVID-19 96

COVID-19 Medical Billing Health Care Access Hospitals 96

Provider Trust

NOVEMBER 22, 2021

As the healthcare industry continues to modernize and more processes become automated, important data has become decentralized. This method requires a flat-file that is updated manually, encoded, then transmitted through a secure channel between two platforms. In other words, you can only work with the data that is in the file.

Compliance 52

Compliance 52

Provider Trust

MARCH 21, 2023

Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs. According to Grimm, the risk of alleged fraud and abuse in Medicare Advantage by plans, vendors, and providers is not to be ignored.

Fraud 52

Fraud Medicare Medicare US Department of Health and Human Services 52

Health Populi

MARCH 27, 2018

On 1st March 2018, two over-arching issues remained with me leaving Las Vegas and #HIMSS18: the central, recognized role of cybersecurity threats in healthcare, and the growing use of consumer-facing technologies for self- and virtual care. Finally, 52% of healthcare organizations do security awareness training annually.

HIPAA 72

HIPAA Hospitals 72

Healthcare Law Blog

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 As individuals continue to live longer beyond retirement and the U.S.

Nursing Homes 52

Nursing Homes Medicaid Medicaid Medicare 52

Healthcare Law Blog

JUNE 22, 2023

This report will provide recommendations to reduce prescription drug costs and regulate PBMs. The Act is extensive and is aimed at increasing competition in the health care market, heightening price transparency, and reducing prescription drug costs. We have summarized key provisions of the Act below.

Hospitals 52

Hospitals Nursing Homes Health Insurance Nurses 52

MedTrainer

AUGUST 2, 2023

When people seek healthcare, there’s a level of implied trust. Through credentialing, healthcare organizations can meet patient expectations by ensuring every physician is unequivocally equipped to treat them. Alignment With Payer Requirements. The faster physicians are credentialed, the sooner they can be reimbursed by payers.

Malpractice 97

Malpractice Compliance Licensing Due Diligence 97

MedTrainer

OCTOBER 26, 2023

Hundreds of required data points and dozens of documents make credentialing a tedious, time-consuming process. In a nutshell, CAQH serves as a central hub where healthcare providers can submit and update all their professional information. CAQH stands for the Council for Affordable Quality Healthcare.

Licensing 52

Licensing Malpractice Hospitals 52

MedTrainer

OCTOBER 26, 2023

In many ways, this speeds up the process, especially if you’re using the tips shared below. Before looking specifically at provider credentialing in Washington state, let’s start with a definition. The primary goal is to ensure that providers meet specific standards for professionalism, education, training, experience, and competency.

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

Health Law RX

JULY 18, 2023

Information Blocking Background In 2016, the 21st Century Cures Act (Cures Act) made sharing electronic health information (EHI) the new normal in healthcare, with the twin goals of encouraging and incentivizing the free flow of patient information among stakeholders and driving efficiencies in healthcare. 1005.2.

Fraud 52

Fraud Compliance Medicaid Medicaid 52

AIHC

FEBRUARY 16, 2024

The GCPG is a reference guide for the health care compliance community and other health care stakeholders and provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. Has the U.S. Learned from an Iconic Canadian History Lesson?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

MedTrainer

JUNE 29, 2023

Imagine keeping a file folder of up-to-date information about every physician working across a healthcare organization — dozens and dozens, if not hundreds of them. If your healthcare organization is still credentialing through pen and paper — and roughly two-thirds of organizations are — it’s time to embrace the power of technology.

Licensing 52

Licensing Compliance Malpractice Hospitals 52

Hall Render

DECEMBER 15, 2023

Partnering with other providers to improve reimbursement rates; 4. Revising payer contracts to keep up with inflation; and 5. The report shows the discount (or premium) between share values and the net asset value (NAV) of REIT assets. UPMC is the second largest elder care provider in southwestern Pennsylvania.

Elder Care 40

Elder Care Hospitals Nurses 40

Hall Render

DECEMBER 14, 2023

Partnering with other providers to improve reimbursement rates; 4. Revising payer contracts to keep up with inflation; and 5. The report shows the discount (or premium) between share values and the net asset value (NAV) of REIT assets. UPMC is the second largest elder care provider in southwestern Pennsylvania.

Elder Care 40

Elder Care Hospitals Nurses 40

AIHC

FEBRUARY 16, 2024

The GCPG is a reference guide for the health care compliance community and other health care stakeholders and provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. Has the U.S. Learned from an Iconic Canadian History Lesson?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Healthcare Law Blog

JANUARY 11, 2022

Morgan Annual Healthcare Conference (the 40 th annual!), Centene reported that their December 31, 2021 data, on a rolling seven-day basis, showed Omicron was running on average at about 60% of the inpatient utilization trend as compared to the Delta variant during its surge.

COVID-19 52

COVID-19 Medicare Medicare COVID-19 Vaccine 52

Redox

AUGUST 8, 2023

How Together We Unlock Healthcare Data to Drive Advanced Analytics Healthcare is sitting on mountains of data Pop quiz: Which industry accounts for about 30% of newly created data around the world and is generating more data faster than any other industry? You guessed it — healthcare.

Governance 52

Governance Compliance Hospitals 52